Motor cortex excitability changes within 8 hours after ischaemic stroke may predict the functional outcome
V Di Lazzaro1, A Oliviero, P Profice
1Istituto di Neurologia, Università Cattolica, Rome, Italy.
Summary
Early assessment of motor cortex excitability using magnetic transcranial stimulation can predict functional recovery in stroke patients. Reduced excitability within 8 hours post-stroke indicates poorer motor outcomes.
Area of Science:
- Neurology
- Neuroscience
- Rehabilitation Medicine
Background:
- Ischemic stroke frequently causes hemiparesis, impacting motor function.
- Predicting functional recovery after stroke is crucial for effective rehabilitation planning.
Purpose of the Study:
- To evaluate motor cortex excitability in acute ischemic stroke patients.
- To determine if motor cortex excitability can predict motor recovery within 15 days.
Main Methods:
- Assessed motor evoked potentials (MEPs) and motor cortex excitability via magnetic transcranial stimulation (MTMS) in 6 hemiparetic patients within 8 hours of stroke.
- Measured MEP latencies and magnetic motor threshold (MMT) in both ischemic and non-ischemic hemispheres.
- Evaluated patient motor function using the National Institutes of Health (NIH) Stroke Scale at baseline and 15 days post-stroke.
Main Results:
- MEP latencies were normal in all patients.
- Two patients with preserved motor cortex excitability showed complete motor recovery (NIH score 0 at 15 days).
- Four patients with reduced motor cortex excitability (higher MMT) exhibited poor motor recovery (NIH score 1.75 at 15 days).
Conclusions:
- Reduced motor cortex excitability in acute ischemic stroke is associated with poor motor recovery.
- MTMS assessment of motor cortex excitability may serve as an early predictor of functional outcome after stroke.
- Early neurophysiological evaluation can guide personalized stroke rehabilitation strategies.
